16 Apr 2012

More decisions expected after hip implant recalls

1:01 pm on 16 April 2012

Medsafe says New Zealand patients should expect more international decisions in coming months on the use of metal-on-metal hip implant devices in the wake of another recall.

The Health Ministry's safety regulator has notified the public about the second recall in two years.

The latest involves the MITCH THR device which has been implanted in dozens of New Zealanders.

In 2010, a device known as the ASR made by British company DePuy was recalled it was found to shed minute shavings, which caused concerns about toxicity. It had been implanted in 507 New Zealanders, some of whom are having it replaced.

Medsafe group manager Stewart Jessamine says the failures have sparked reviews in the United States and the United Kingdom of the modern metal-on-metal devices.

"I expect over the next six or nine months there'll be a series of stories and regulatory decisions made about metal-on-metal hip replacements, that may affect patients in New Zealand."

Medsafe says the primary cause of the recall of the MITCH THR is the loosening and movement of part of the hip replacement joint.

It says not all those who had the implant will need it replaced, but annual checks will be needed for the life of the device.

Younger people main recipients

Wellington surgeon Geoffrey Horne says mainly younger people will have received the device.

"For people over the age of 65 or 70, none of them will have had metal-metal hips, so I don't think they should be concerned. But the younger patients may be concerned and in that case they should contact their orthopaedic surgeon."

Professor Horne says theory behind the devices was that they would last longer, and the marketing was intense, leading to some patients asking for the metal type of implant. He said he has refused some such requests.

He says surgeons will be very wary about metal-on-metal replacement devices in future.

Orthopaedic Association chief executive Flora Gilkison told Morning Report that minute amounts of metal debris from the metal implants can enter the bloodstream.

Inquiry call

Patient advocate James Elliott says the latest recall backs demands for an inquiry by Parliament's health select committee.

"New Zealand is now part of what can fairly I think be described as a world-wide medical disaster in relation to metal-on-metal implant hips.

"It may be that there are more such devices that are going to be recalled or have serious issues."

Labour Party health spokesperson Maryan Street says she will try again to get a Parliamentary inquiry into metal-on-metal hip replacements.

Ms Street says National Party MPs on Parliament's health select committee defeated her first attempt to have it mount an inquiry but answers are needed on who got the devices in this country, metal toxicity, replacement surgery and who's responsible.